Refractory anemia without ring sideroblasts, so stated

This code represents a myelodysplastic syndrome (MDS) characterized by persistent anemia that does not respond to standard treatments, and importantly, the absence of ring sideroblasts in the bone marrow. It indicates a primary bone marrow disorder where the body fails to produce healthy red blood cells, leading to chronic anemia.

Use this code for patients diagnosed with refractory anemia where bone marrow biopsy confirms less than 15% ring sideroblasts. This diagnosis is typically made after other causes of anemia have been ruled out and the anemia persists despite erythropoietic stimulating agents or other therapies. Documentation should clearly state "refractory anemia without ring sideroblasts."

• Distinguish from other MDS types, especially those with ring sideroblasts (e.g., D46.1).
• Ensure documentation explicitly states "without ring sideroblasts" to support this specific code.
• Code any associated pancytopenia or other cytopenias separately if documented.